This thesis deals with the form of relationship actors (client and social worker) in social work profession, through the optics of interactive model. Thesis also deals with the role, purpose, important aspects, principles and values of helping relationship with regard to working with postmodern (relational) loss. The critical discussion treats with the possible relationship difficulties and paradoxes, which are viewed by ethical perspective. In all of the formulated relational paradoxes is valid, that the social worker has to think, reflect and be able to have publicly defend his dealing with the client

Bakgrund: När patienter vårdas i sen palliativ fas är existentiellt lidande något som kan drabba patienterna oavsett om de vårdas på vårdavdelningar, genom hemsjukvård eller på specialiserad palliativ vårdavdelning. Detta kan innebära att de behöver få stöd och lindring i sitt existentiella lidande av vårdpersonalen då existentiella behov ska bli mötta för att dessa patienter ska erhålla en god livskvalitet. Syfte: Att beskriva vårdpersonals erfarenheter av att vårda patienter med existentiellt lidande i sen palliativ fas. Metod: Kvalitativ litteraturstudie med beskrivande syntes.Resultat: Efter analysen framkom två teman och sex subteman. Temat Meningsfullt vårdande inkluderar Att få patienterna att öppna upp genom förtroendefulla relationer och Att hitta sätt att stödja patienterna. Temat Utmaningar i vårdandet inkluderar Att finna en balans i sin professionella roll, Att identifiera existentiellt lidande, Att hantera svåra samtal och Att begränsas av yttre förutsättningar. Slutsats: Vårdpersonalen använder enkla medel i omvårdnaden såsom att enbart dela tystanden vilket ger ett meningsfullt vårdande men möjligheterna att identifiera och lindra patienternas existentiella lidande hämmas av tidsbrist och patienternas mentala och fysiska hälsa. Även vårdpersonalens egen dödsrädsla och tron att deras kunskaper brister eller att samtal om döden ökar lidandet minskar möjligheterna för att lindra existentiellt lidande. / Background: Existential suffering can afflict patients in late palliative phase, regardless whether they are cared for in a ward, receive home healthcare or in a specialized palliative care unite. This may mean that health professionals need to support the patients and provide relief in their existential suffering since meeting their existential needs is important in order for the patients to receive a good quality of life. Aim: To describe health professionals' experiences of caring for patients with existential suffering in late palliative phase. Method: A qualitative approach, through a literature study with a descriptive synthesis. Results: After the analysis two themes and six subthemes emerged. The theme Meaningful caring includes Getting the patients to open up through trustful relationships and Finding ways to support the patients. The theme Challenges in caring includes Finding a work-life balance, Identifying existential suffering, Managing difficult conversations and Being limited by external conditions. Conclusion: Nursing actions such as solely sharing the silence resulting in meaningful caring are often used but time restraints and the patients’ overall health conditions limits the possibilities to identify and ease their existential suffering. Additionally, health professionals' death anxiety and experienced knowledge gaps or beliefs that death conversations increase suffering limits the possibilities to ease existential suffering.

Bakgrund: Hemodialys är en livslång behandling av njursvikt som är en allvarlig kronisk sjukdom. Hemodialyspatienter har frekventa möten med sjuksköterskor och utvecklar ofta en nära kontakt som kan sträcka sig över flera år. Sjuksköterskan behöver arbeta personcentrerat för att främja patienternas hälsa. Syfte: Syftet med studien var att belysa kroniskt njursjuka patienters upplevelser av att leva med hemodialys.Metod: Litteraturstudie med kvalitativ ansats. Olika sökblock byggdes upp baserade på forskningsfrågan och sökningar utfördes i databaserna CINAHL och PubMed. Efter att ha relevans- och kvalitetsgranskats befanns 12 artiklar vara relevanta för analys. Forsberg och Wengströms förenklade innehållsanalys användes för att analysera materialet.Resultat: Fem teman trädde fram: Tiden då, nu och framåt, Uppfattningen om jaget och kroppen, Relationer, Beroenden och begränsningar samt Förlust, acceptans och tacksamhet.Konklusion: Livet med hemodialys påverkar patienterna både socialt, mentalt och fysiskt. Patienterna upplevde sig begränsade, i beroendeposition och deras sociala relationer förändrades. Sjuksköterskan behöver finnas tillgänglig för patienten för att denne ska uppleva hälsa.Nyckelord: Hemodialys, mellanmänskliga relationer, patient, personcentrerad vård upplevelse. / Background: Hemodialysis is a lifelong treatment of chronic kidney failure - a severe and demanding disease. Patients going through hemodialysis have frequent interaction with nurses and often develop a personal relationship which can continue for several years. The nurse has to apply patient centered care to promote health for the patient.Aim: The aim of this study was to illuminate the lived experience of patients with chronic kidney failure receiving hemodialysis.Method: This study was conducted as a literature review with a qualitative approach. The database searches were conducted in CINAHL and PubMed. 12 articles passed the relevance- and quality review. A content analysis method of five steps was used to analyse the material.Result: Five themes emerged; The past, the now and the future, The perception of self and the body, Relationships, Dependency and limitations and Loss, acceptance and gratitude.Conclusion: Life on hemodialysis affects the patients both socially, mentally and physically. The patients felt restricted, in dependency and that their social relationships were changed. The nurse has to be there for the patient in order for the patient to experience healthKeywords: Experience, hemodialysis, human-to-human relationship, patient, patient centered care.

Malgré son caractère d’animal exotique et venu d’ailleurs, le singe a fait l’objet d’une attention toute particulière de la part de la culture grecque et gréco-romaine. L’animal, que l’imaginaire contemporain considère comme le plus proche de l’homme en vertu de ses caractères morphotypiques et éthologiques, était au contraire conçu par les Anciens comme l’être vivant le plus aberrant de l’humanité, justement en raison d’une pareille similarité considérée comme échouée. L’imaginaire grec concernant le singe se nourrit de pratiques relationnelles en grande partie différentes de celles qui peuvent concerner l’observateur moderne : en effet, les Grecs ne connaissaient pas de grands singes, et le représentant prototypique des primates non-humains était pour eux le magot. En analysant le portrait-robot que les sources zoologiques et médicales nous délivrent concernant la forme du singe, son éthologie et sa façon de se déplacer, il est possible de comprendre d’autres aspects apparemment plus obscurs faisant partie des représentations culturelles conçues par les Grecs pour cet animal. Le singe s’intègre en particulier dans les mêmes configurations symboliques que d’autres caractères de l’imaginaire grec, avec une spécificité propre lorsqu’il est associé à des figures imparfaitement viriles ou masculines telles que les enfants ou les eunuques, ainsi que les homosexuels efféminés. Son association à de milieux sociaux d’élite très souvent liés à une vie considérée comme débauchée, sa condition marquée par l’imperfection physique ainsi qu’une soumission au maître toujours jugée comme précaire, font en sorte que le singe soit considéré comme le véritable geloion mimēma de l’être humain et de son modèle de perfection, à savoir le mâle adulte de condition libre. / Despite being an exotic animal and coming from elsewhere, monkeys have been the subject of special attention from Greek and Greco-Roman culture. The animal that the contemporary imagination considers the closest to man by virtue of its morphotypical and ethological characters was, on the contrary, conceived by the ancients as the most aberrant living being when compared to man precisely because of such a failed similarity. Ancient Greek imaginary about monkeys feeds on relational practices largely different from those that may concern human beings nowadays: ancient Greeks indeed did not know any great apes and the prototypical representative of the non-human primates was the Barbary ape. By analysing the information that zoological and medical sources give us concerning both the anatomy and the ethology of monkeys, it is possible to understand other seemingly more obscure aspects that are part of the cultural representations conceived by the Greeks for this animal.In particular, monkeys enter into the same symbolic configurations as other figures in ancient Greek imagery especially when associated with imperfectly virile or masculine figures such as children or eunuchs as well as effeminate homosexuals. The association with elite social circles very often linked to a life considered debauched and their condition marked by physical imperfection in addition to a submission to the master always considered as precarious, make the monkey be considered a real geloion mimēma, a laughable counterfeit of the human being and of his perfect prototype, namely the adult male of free condition.

[pt] Os estudos de Ciência, Tecnologia e Sociedade (CTS) e os estudos sociais e culturais das ciências abriram novos espaços ontológicos e epistemológicos que questionam a epistemologia universalista moderna, revelando as controvérsias e redes de conexões envolvidas no desenvolvimento de diferentes disciplinas científicas, antes obscurecidas pela modernidade. Com base nessas perspectivas, a presente tese visa suscitar reflexões acerca das controvérsias e particularidades históricas, ontológicas e epistemológicas no desenvolvimento dos estudos de comportamento animal, tendo em vista que se desenvolveram a partir de diálogos interdisciplinares e de dissolução de fronteiras entre conhecimento local e científico. Pretende-se discutir as diferentes apreensões de alteridades animais a partir dos estudos do comportamento animal, e suas relações com outros tipos de olhares poéticos sobre os animais. O advento da etologia abriu caminho para novas compreensões acerca das capacidades sociais, cognitivas e subjetivas dos animais não-humanos em condições de campo. Essas novas compreensões suscitaram reflexões críticas acerca da mente animal, confrontaram as ideias modernas cartesianas, mecanicistas e funcionais, dos animais como máquinas ou autômatos insensíveis e transformaram as relações entre humanos e animais não-humanos. O caráter interdisciplinar e multimetodológico que a etologia assumiu no decorrer do seu desenvolvimento no século XX como estudo biológico e evolutivo do comportamento, possibilitou o diálogo entre as ciências biológicas e as ciências sociais, bem como permitiu o atravessamento de fronteiras entre humanidade e animalidade. Embora Konrad Lorenz, Nikolaas Tinbergen e Karl von Frisch sejam considerados, pela História (Monumental) das Ciências, como os legítimos fundadores da etologia, ainda há controvérsias acerca de sua origem e constituição como disciplina científica, tendo em vista que já se falava em etologia desde antes de Charles Darwin, que já escrevia acerca da dimensão evolutiva do comportamento animal no século XIX. Antes da sua consolidação como disciplina científica no século XX, a etologia foi (re)definida através de diferentes perspectivas (behaviourismo, psicologia comparada americana, etologia objetivista européia, etologia vitalista, entre outras) constituindo uma trajetória peculiar como ciência multidimensional. Dentre controvérsias e particularidades, a presente tese enfatiza a relação de respeito mútuo e rivalidade entre dois importantes fundadores da disciplina: Konrad Lorenz e Jakob von Uexkull. Uexkull influenciou significativamente as ideias de Lorenz acerca do comportamento e subjetividade dos animais. No entanto, essa influência terminou em uma rivalidade, tendo em vista as diferentes posições epistemológicas e políticas entre o darwinista evolucionista alemão e o vitalista estoniano. Nas linhas de fuga da História e Epistemologia das ciências, é importante considerar que Uexkull, desconhecido por muitos etólogos atuais, com sua teoria dos mundos-próprios (Umwelt) e perspectiva neovitalista, reconheceu os animais somo sujeitos, revolucionando os conhecimentos sobre a ação e percepção dos animais. E é possível que Lorenz posteriormente tenha reconhecido os animais como sujeitos com base nas reflexões de Uexkull. Com estas reflexões, a presente tese pretende explicitar como a etologia desenvolveu-se de forma não linear e múltipla, incorporando diferentes perspectivas, conceitos e metodologias ao longo de sua história. Em outras palavras, serão discutidos os diferentes caminhos e linhas de fuga ontológicas e epistemológicas percorridos nos estudos do comportamento animal, que transformaram a etologia numa ciência biossocial e fronteiriça, com uma história não-fatual que abrange diferentes dimensões, métodos, conceitos, praticas, disciplinas e objetos. / [en] The Science, Technology and Society (STS) studies and the social and cultural studies of the sciences have opened up new ontological and epistemological spaces that question modern universalist epistemology, revealing the controversies and networks of connections involved in the development of different scientific disciplines previously obscured by modernity. Based on these perspectives, this thesis aims to elucidate the controversies and historical, ontological and epistemological particularities in the development of animal behavior studies, since they have developed from interdisciplinary dialogues and the dissolution of borders between local and scientific knowledge. It is intended to discuss the different apprehensions of animal alterities from the studies of animal behavior, and their relations with other types of poetic looks on animals. The advent of ethology paved the way for new insights into the social, cognitive, and subjective capacities of nonhuman animals under field conditions. These new insights have elicited critical reflections about the animal mind, confronted modern cartesian, mechanistic, and functional ideas of animals like machines or insensitive automata and transformed relations between humans and nonhuman animals. The interdisciplinary and multi-methodological character that ethology assumed in the course of its development in the twentieth century as a biological and evolutionary study of behavior, enabled the dialogue between the biological sciences and the social sciences, as well as allowed the crossing of borders between humanity and animality. Although Konrad Lorenz, Nikolaas Tinbergen and Karl von Frisch are considered by the (Monumental) History of Sciences as the legitimate founders of ethology, there is still controversy about its origin and constitution as a scientific discipline, since ethology was already spoken since before Charles Darwin, who was already writing about the evolutionary dimension of animal behavior in the nineteenth century. Before its consolidation as a scientific discipline in the twentieth century, ethology was (re) defined through different perspectives (behaviorism, american comparative psychology, european objectivist ethology, vitalist ethology, among others) constituting a peculiar trajectory as multidimensional science. Among the controversies and particularities, the present thesis emphasizes the relation of mutual respect and rivalry between two important founders of the discipline: Konrad Lorenz and Jakob von Uexkull. Uexkull influenced significantly Lorenz s ideas about animal behavior and subjectivity. However, this influence ended in a rivalry, given the different epistemological and political positions between the German evolutionist Darwinist and the Estonian vitalist. In the escape lines of the History and Epistemology of the Sciences, it is important to consider that Uexkull, unknown to many today s ethologists, with his theory of the own-worlds (Umwelt) and neovitalist perspective, recognized animals as subjects, revolutionizing knowledge about action and perception of animals. And it is possible that Lorenz later recognized the animals as subjects based on Uexkull s reflections. With these reflections, the present thesis aims to explain how ethology has developed in a non-linear and multiple way, incorporating different perspectives, concepts and methodologies throughout its history. In other words, we will discuss the different ontological and epistemological paths and escape lines routes in animal behavior studies that have turned ethology into a biossocial and frontier science with a non-factual history that encompasses different dimensions, methods, concepts, practices, disciplines and objects.

This study seeks to examine the precise way it may be said that God takes risks in creating and governing this world. In order to articulate this model of providence various texts of scripture are studied which have either been overlooked or interpreted differently in discussions of divine providence. These texts reveal a deity who enters into genuine give-and-take relations with creatures, a God who is genuinely responsive and who may be said to take risks in that God does not get everything he desires in these relationships. Furthermore, the traditional texts used to defend the no-risk view of providence are examined and shown that they do not, in fact, teach the idea that God is the cause of everything which happens in the world such that the divine will is never thwarted in the leas detail. The biblical teaching of God in reciprocal relations with his creatures is then discussed in theological and philosophical terms. The nature of God is here understood as loving, wise, faithful yet free, almighty, competent and resourceful. These ideas are explicated in light of the more traditional theological/philosophical understanding of God. Finally, some of the implications of this relational model of God are examined to see the ways in which it may be said that God takes risks and whose will may be thwarted. The crucial watershed in this regard is whether or not there is any conditionality in the godhead. The no-risk view denies, while the risk model affirms, that some aspects of God's will, knowledge, and actions are contingent. In order to grasp the differences between the two models the doctrines and practices involved in salvation, the problem of evil, prayer and guidance are examined to see what each model says about them. It is claimed that· .the relational or risk model is superior to the no-risk model both in terms of theoretical coherence and the practice of the Christian life. / Philosophy, Practical & Systematic Theology / Th. D. (Sytematic Theology)

This research project investigates Confucian thinker Dai Zhen (1724-1777) and Jewish thinker Emmanuel Levinas’s (1906-1995) philosophical discourses on desire from a comparative perspective. First, I look at Dai Zhen and Levinas individually each in their own philosophical contexts, while framing my readings with parallel structure that pivots on a hermeneutic strategy to examine their ideas of desire within the larger prospect of the human relation with transcendence. Then, my inquiry leads to a critical analysis of several interesting issues yielded in my interpretive readings of the two thinkers as regards transcendence and immanence and the self-other relationship. Methodologically, my study combines careful textual analysis, philosophical reflection, and historical sensitivity. We might want to say that there is in fact no correlative of the Levinasian desire in Dai Zhen’s philosophy. Dai Zhen’s notion of desire perhaps comes closer to Levinas’s concept of need. However, the disparity of their conceptual formulations does not keep us from discerning their shared ethical concern for the other, the weak, marginalized, and underprivileged group of society, which provides me the very ground for a dialogical comparison between the two thinkers. Henceforth, my writing is hinged on a comprehension of their conception of desire as an articulation of human striving for what is lying beyond themselves, as a redefinition of the being or essence of humankind in relation to the transcendent which in both philosophers’ ethical thinking is translated into a sympathetic understanding of and care for the other, particularly the stranger, the widow, the orphan, the young, the weak and the like. Through the comparative study of the two thinkers’ ideas of desire, I want to argue that “desire,” which is most readily directed to human egoism and instinctive propensity in both Confucian and Western philosophical traditions, can be at once the very driving force to open us to the other beyond ourselves and an actual moral creativity to produce ethical being out of material existence.

This research project investigates Confucian thinker Dai Zhen (1724-1777) and Jewish thinker Emmanuel Levinas’s (1906-1995) philosophical discourses on desire from a comparative perspective. First, I look at Dai Zhen and Levinas individually each in their own philosophical contexts, while framing my readings with parallel structure that pivots on a hermeneutic strategy to examine their ideas of desire within the larger prospect of the human relation with transcendence. Then, my inquiry leads to a critical analysis of several interesting issues yielded in my interpretive readings of the two thinkers as regards transcendence and immanence and the self-other relationship. Methodologically, my study combines careful textual analysis, philosophical reflection, and historical sensitivity. We might want to say that there is in fact no correlative of the Levinasian desire in Dai Zhen’s philosophy. Dai Zhen’s notion of desire perhaps comes closer to Levinas’s concept of need. However, the disparity of their conceptual formulations does not keep us from discerning their shared ethical concern for the other, the weak, marginalized, and underprivileged group of society, which provides me the very ground for a dialogical comparison between the two thinkers. Henceforth, my writing is hinged on a comprehension of their conception of desire as an articulation of human striving for what is lying beyond themselves, as a redefinition of the being or essence of humankind in relation to the transcendent which in both philosophers’ ethical thinking is translated into a sympathetic understanding of and care for the other, particularly the stranger, the widow, the orphan, the young, the weak and the like. Through the comparative study of the two thinkers’ ideas of desire, I want to argue that “desire,” which is most readily directed to human egoism and instinctive propensity in both Confucian and Western philosophical traditions, can be at once the very driving force to open us to the other beyond ourselves and an actual moral creativity to produce ethical being out of material existence.

This study seeks to examine the precise way it may be said that God takes risks in creating and governing this world. In order to articulate this model of providence various texts of scripture are studied which have either been overlooked or interpreted differently in discussions of divine providence. These texts reveal a deity who enters into genuine give-and-take relations with creatures, a God who is genuinely responsive and who may be said to take risks in that God does not get everything he desires in these relationships. Furthermore, the traditional texts used to defend the no-risk view of providence are examined and shown that they do not, in fact, teach the idea that God is the cause of everything which happens in the world such that the divine will is never thwarted in the leas detail. The biblical teaching of God in reciprocal relations with his creatures is then discussed in theological and philosophical terms. The nature of God is here understood as loving, wise, faithful yet free, almighty, competent and resourceful. These ideas are explicated in light of the more traditional theological/philosophical understanding of God. Finally, some of the implications of this relational model of God are examined to see the ways in which it may be said that God takes risks and whose will may be thwarted. The crucial watershed in this regard is whether or not there is any conditionality in the godhead. The no-risk view denies, while the risk model affirms, that some aspects of God's will, knowledge, and actions are contingent. In order to grasp the differences between the two models the doctrines and practices involved in salvation, the problem of evil, prayer and guidance are examined to see what each model says about them. It is claimed that· .the relational or risk model is superior to the no-risk model both in terms of theoretical coherence and the practice of the Christian life. / Philosophy, Practical and Systematic Theology / Th. D. (Sytematic Theology)

The purpose of this study was to explore nurse-patient encounters from the perspective of the Home Healthcare Registered Nurse. A qualitative descriptive design was used to collect data from a purposive sample of 20 home healthcare registered nurses from Connecticut, Massachusetts, and Rhode Island currently or previously employed as a home healthcare nurse. Four themes and one interconnecting theme emerged from the data: Objective Language; Navigating the Unknown; Mitigating Risk; Looking for Reciprocality in the Encounter; and the interconnecting theme of Acknowledging Not All Nurse-Patient Encounters Go Well. One goal of the study was to propose an empirically informed definition of what constituted a difficult encounter. An important early finding was that the terms difficult patient and difficult encounter were not generally used by study participants. HHC RNs voiced a preference for objective and nonjudgmental language to communicate outcomes of nurse-patient encounters. Three types of HHC RN-patient interactions emerged from the data, with constructive encounters the norm and non-constructive or destructive encounters less frequent. A constructive encounter is when two or more human beings, the nurse on the one side, and the patient, caregiver, or both on the other, interact to achieve a mutually agreed upon outcome. A nonconstructive encounter is when one or more human beings obstruct efforts to achieve at least one positive outcome. A destructive encounter is when one or more human beings direct anger at or physically aggress toward another human being. Strategies to promote reciprocality are routinely employed during HHC RN-patient encounters, but HHC RNs who miss cues that a strategy is ineffective or failed may be at risk in the home. Study data lend support to key concepts, assumptions, and propositions of Travelbee’s (1971) Human-to-Human Relationship Model. Study results provide a foundation for further research to increase the understanding, recognition, and development of empirically derived responses to non-constructive or destructive encounters such that HHC RNs are safe and best able to meet patients’ healthcare needs.